Diagnosis of gastrointestinal stromal tumor: Current status

Asymptomatic mesenchymal tumors are often found out by routine exams especially by endoscopy as submucosal tumors in our country. A great part of them is speculated to be GIST, however the diagnosis is clinically difficult for their non-specific radiological or clinical features. It is advisable to say all GISTs are potentially malignant, although they rarely behave in a malignant fasion on the long clinical course. The gold standard for the diagnosis of GIST depends on immunohistochemistry, however the mucosal coverage over the tumor hinders getting biopsy specimen by routine biopsy. Therefore EUS-FNAB is recommended to obtain a biopsy specimen and to have histological diagnosis, if possible. A tyrosine kinase inhibitor, Imatinib mesylate, is a key drug and the effect on GIST is closely related to the genotype. Evaluation of malignant potential for pathologically diagnosed GIST is clinically of great importance.